Medical Expense Reimbursement Plan (MERP)

Lleve su estrategia de ahorro en seguros de salud al siguiente nivel con una Tarjeta Diferencial MERP

The Difference Card specializes in administering Medical Expense Reimbursement Plans (MERP). A MERP is not part of a standard benefits offering, but a MERP can be a valuable tool to achieve various employer health plan objectives, such as benefit improvement, cost reduction and tax savings. 

We will outline what a MERP (Medical Expense Reimbursement Plan) is, describe its usage rules and detail several scenarios where a MERP might be an employer’s preferred approach for health plan design, implementation or renewal. A MERP could be just the solution you or your client needs to combat the rising cost of healthcare.  

¿Qué es un MERP y cómo funciona?

What a MERP Is

A MERP, or Medical Expense Reimbursement Plan, is an employer-sponsored benefit plan that helps employees cover eligible medical expenses.

It is a type of reimbursement plan that allows employees to receive reimbursement for out-of-pocket medical costs incurred during the plan year.

How a MERP Works

In a MERP, the employer establishes the plan and sets the rules and guidelines for eligible expenses and reimbursement. Employees contribute to the plan through pre-tax payroll deductions, reducing their taxable income. When employees incur medical expenses, they submit claims along with supporting documentation to the plan administrator for reimbursement.

Role of the Plan Administrator

The plan administrator, such as The Difference Card, reviews the claims to ensure they meet the criteria outlined in the plan documents. Once approved, eligible expenses are reimbursed to the employee according to the reimbursement process specified in the plan.

 

Direct Payment Option

Additionally, some services like copays can be swiped directly at the doctor’s office on the employee’s Difference Card Mastercard.

Types of Expenses Covered

MERPs typically cover a wide range of medical expenses, including doctor’s visits, hospital services, prescription medications, and other healthcare-related costs. However, it is important to note that specific expenses and reimbursement limits may vary depending on the plan design.

 

Employer Flexibility in Plan Design

Employers have flexibility in designing the MERP to suit their needs. They can determine the contribution amounts, establish guidelines for eligible expenses, and choose the reimbursement process that aligns with their administrative capabilities.

Compliance Requirements

MERPs are subject to compliance with applicable regulations, such as the Internal Revenue Code and the Employee Retirement Income Security Act (ERISA). Employers must ensure that the plan meets the necessary legal requirements to maintain its tax-favored status. The Difference Card offers complimentary compliance services to support clients and protect them from penalties.

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The Benefits of Medical Expense Reimbursement Plans

Los planes de reembolso de gastos médicos (MERP) ofrecen varias ventajas tanto a las empresas como a los empleados:

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    Financial assistance

    MERPs provide employees with financial support by offering reimbursement for eligible medical expenses, helping to alleviate the financial burden of healthcare costs.

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    Cost control

    MERPs allow employers to set contribution limits and choose eligible expenses, giving them more control over healthcare expenses and helping to manage costs effectively.

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    Tax advantages

    Contributions made to MERPs are often tax-deductible for employers, providing potential tax savings via tax deductions.

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    Customization

    MERPs can be customized to meet the specific needs of the employer and the workforce, allowing for flexibility in designing benefit offerings.

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    Employee satisfaction

    By providing access to reimbursement for medical expenses, MERPs contribute to improved employee satisfaction and peace of mind.

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    Retention and Productivity

    Offering MERPs as part of a comprehensive benefits package can help attract and retain talented employees, while also promoting a healthier workforce, which can lead to increased productivity.

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    Cumplimiento

    MERPs must comply with relevant regulations, ensuring the plan meets legal requirements to maintain its tax-favored status.

In summary, MERPs offer financial assistance, cost control, tax advantages, customization, employee satisfaction, retention and productivity benefits, and compliance advantages for employers and employees. These health plans can play a significant role in managing healthcare costs and supporting the financial well-being of employees.

Advantages of a Difference Card MERP

While a MERP might be a lesser-known benefit product offering, the advantages are no secret. The ability to fully customize plan designs while also saving the employer money on their health insurance spend is just one of the many reasons to consider a MERP.

More advantages of using a MERP to design employee benefits include: 

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    Flexibility

    The MERP offered by Difference Card allows employers the freedom to switch health insurance carriers and adjust health plan designs without losing the benefits of the MERP.

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    Detailed Plan Reporting

    Difference Card provides comprehensive reporting, offering daily, weekly, and monthly utilization data by facility and provider, giving employers valuable insights into plan usage.

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    Savings Tracking

    Difference Card tracks the success of the health insurance plan through savings achieved, providing a tangible measure of the plan’s effectiveness.

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    Guaranteed Savings

    Difference Card offers the option to include a reinsurance policy, ensuring savings are guaranteed.

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    Specific Funding for Services

    The MERP provides funds for various medical services, including doctor visits, emergency room care, urgent care, diagnostic testing, hospitalization and surgery, pharmacy expenses, and more.

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    Auto Substantiation

    Claims are automatically substantiated, simplifying the process for employees through debit card integration at the copay level.

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    Dedicated Account Management Team

    Difference Card assigns a full Account Management Team to assist in the success of the plan, including providing employee communication materials in printed English and Spanish language guides and customized client videos.

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    Compliance Package

    Difference Card offers a comprehensive compliance package, including plan documents, Summary of Benefits and Coverage (SBCs), Summary Plan Descriptions (SPDs), and non-discrimination testing.

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    Premium Equivalent Rates

    Difference Card’s Actuarial Team calculates premium equivalent rates, allowing employers to set employee and employer contributions and COBRA rates.

Medical Expense Reimbursement Plans are so effective because, unlike an HRA, they can help employers purchase cost-effective single options from insurance carriers and customize funding to offer multiple plans to employees.

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Gente de negocios discutiendo sobre un nuevo proyecto empresarial en la oficina

Employee Education – More Benefits at a Lower Cost

The Difference Card Account Executive Team will guide employer groups through every step of the process during implementation and open enrollment. Each Difference Card client gets a dedicated Account Executive along with virtual Open Enrollment Resources page that contains client specific benefit plans, a step-by-step video guide on how to use The Difference Card and any additional necessary educational materials.  

When discussing MERPs with their employees, employers should focus on clear and transparent communication. It is essential to explain the purpose and benefits of the MERP, emphasizing how it helps employees manage their medical expenses effectively.  

The Difference Card will provide comprehensive information about the eligibility criteria, reimbursement process, and available services. We will also highlight any flexibility and customization options that the MERP offers. Clear communication about contribution amounts, coverage limitations, and the role that The Difference Card plays is crucial.  

Los empleadores deben fomentar el diálogo abierto, abordando cualquier pregunta o preocupación que los empleados puedan tener, y proporcionar recursos educativos de La Tarjeta Diferencia para asegurar que los empleados entiendan cómo maximizar los beneficios del MERP.

Al fomentar debates abiertos e informativos, los empresarios pueden promover el compromiso de los empleados, su satisfacción y la utilización del MERP en todo su potencial.

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Explore las posibilidades que ofrece la Tarjeta Diferencia, incluido el potencial para mejorar las prestaciones de sus empleados y agilizar la gestión de la asistencia sanitaria.

In addition to Medical Expense Reimbursement Plans (MERPs), The Difference Card offers a comprehensive suite of product offerings, including Health Reimbursement Arrangements (HRAs), Health Savings Accounts (HSAs), Dependent Care Accounts, Flexible Spending Accounts (FSAs), Difference Benefits Admin System, Lifestyle Spending Accounts, Commuter and Transit Accounts, Dental Difference, The Difference Guarantee, and Compliance Services.  

Cada una de estas ofertas está diseñada para ofrecer soluciones a medida, potenciar las ventajas fiscales y simplificar las tareas administrativas.

Con la posibilidad de acumular múltiples opciones de prestaciones en una sola tarjeta, The Difference Card se compromete a ofrecer planes de prestaciones sanitarias integrales que se ajusten a las necesidades exclusivas de sus clientes.

Take the next step in optimizing your benefits strategy by exploring The Difference Card’s full range of offerings and discovering how they can revolutionize your employee benefits experience. 

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